COMMITTEE OF THE WHOLE MEETING. WEDNESDAY, NOVEMBER 14, :00 P.M West 25 th Street United Bank Building (Sixth Floor) Ohio Room

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1 COMMITTEE OF THE WHOLE MEETING WEDNESDAY, NOVEMBER 14, :00 P.M West 25 th Street United Bank Building (Sixth Floor) Ohio Room AGENDA 1. Call to Order Rev. Benjamin F. Gohlstin, Sr., Board Chair 2. Approval of Minutes: - Community Relations & Advocacy Committee: September 5, Committee of the Whole Meeting: October 17, Advocacy Action Agenda - (action request) Beth Zietlow-DeJesus 2018 Review 2019 Draft 4. Fentanyl Campaign Beth Zietlow-DeJesus - (information only) 5. Finance Reports (action request) Felicia Harrison - Board Voucher & Expenditure Reports October Peer Seal of Quality for Adult Care Facilities (ACFs) Program - (action request) Scott Osiecki - Individual Peer Supporters - $50.00 per Home Visit ($25 per peer in teams of two) 7. Contracts (action request) - Felicia Harrison (*Pass Through) a) U.S. Dept. of Health and Human Services, Substance Abuse & Mental Health Services Administration Assisted Outpatient Treatment (AOT) Grant Supplemental Technical Assistance Funding - $25, (Individual Trainers Yet to be determined) b) *Ohio Department of Rehabilitation & Corrections (ODRC) Intensive Community Treatment (ICT) Team for Cleveland Adult Parole Office - Recovery Resources - $275, c) Cuyahoga County Juvenile Court (CCJC) Detention Center - Mental Health Services in the Detention Center - Applewood Centers, Inc. - $400, d) Security Services Contract - Safe Choice LLC - $17.50 hourly rate Annual Estimate for CY $127, e) ADAMHS Board of Cuyahoga County Annual Meeting Monday, May 13, Cleveland Marriott East, Harvard Rd., Warrensville Heights Not to exceed $15, f) Cultural Competency Breakfast Monday, January 28, at Ariel International Center - Ariel International Center, Caterer & personal service contract with Dr. Ciara Dennis Morgan Not to exceed $5, Page 1 of 2

2 8. Amendments to Contracts - (action request) - Felicia Harrison - (*Pass Through) a) *Amendment to Res. No Approval of Contracts - Projects for Assistance in Transition from Homelessness (PATH) and Acceptance of additional Housing Funding - FrontLine Service - $13, Increase b) Amendment to Res. No Consulting contract for Remote Network Administration - Christopher P. Tomaro extension of contract term through March 31, 2019 c) Amendment to Res. No Approval & Ratification of Service Provider Contracts: Common Pleas Court/Corrections Planning Board (CCPB) Residential Services for Men who are Dually Diagnosed (Contractor: Catholic Charities/Matt Talbot in the amount of $160,000.00) - Correction to reflect required match; $80, from CCPB and $80, from ADAMHS Board 9. Identify Consent Agenda Rev. Gohlstin, Board Chair 10. Policy Statement Renewal (action request) Bob Garrity Notification & Review Of Reportable Incidents & MUI s 11. Discussion: Dental & Podiatry Preventive Care Rev. Gohlstin 12. Review of CY2019 ADAMHS Board Budget Executive Team 13. Old/New Business BOARD OF DIRECTORS Rev. Benjamin F. Gohlstin, Sr., Chairperson Eugenia Kirkland, LSW, MSSA, CDCA, Vice Chair J. Robert Fowler, Ph.D., Second Vice Chair Reginald C. Blue, Ph.D. Gregory X. Boehm, M.D. Erskine Cade, MBA Elsie Caraballo Cassi Handler Gwendolyn A. Howard, LSW, MSSA Katie Kern-Pilch, ATR-BC, LPC-S Steve Killpack, MS Max M. Rodas, MA Sharon Rosenbaum, MBA Hugh B. Shannon Harvey A. Snider, Esq. Mary M. Step, Ph.D. Page 2 of 2

3 Agenda Process Sheet Date: November 14, 2018 Community Relations & Advocacy Committee Faith-Based Outreach Committee Planning & Oversight Committee Finance & Operations Committee Committee of the Whole General Meeting Topic: Acceptance of 2018 Advocacy Action Agenda Review & Approval of 2019 Advocacy Action Agenda Contractual Parties: N/A Term: January 1, 2019 through December 31, 2019 Funding Sources: Amount: ADAMHS Board Funding if Needed N/A New Program Continuing Program Expanding Program Other Service Description: The Advocacy Action Agenda is designed to inform the Board, community and system of the advocacy goals for each year. Background Information: The ADAMHS Board of Cuyahoga County develops and approves an Advocacy Action Agenda each year to develop messages to legislators, state agencies, policy makers, clients, families, providers and the general public to advance important behavioral health issues. At the beginning of each year, the prior year s Advocacy Action Agenda is reviewed to determine success and a new agenda is set for the current year. The Advocacy Action Agenda for 2018 was developed with the over-arching goal of promoting recovery of individuals living with mental illness and addictions by adopting and acting on the five Recovery Oriented System of Care principles: 1. Focusing on Clients and Families 2. Ensuring Timely Access to Care 3. Promoting Healthy, Safe, and Drug-Free Communities 4. Prioritizing Accountable and Outcome-Driven Financing 5. Locally Managing Systems of Care The Advocacy Action Agenda is in addition to the advocacy and collaboration that the Board provides on a daily basis through its work of ensuring that mental health, addiction treatment and prevention and recovery services and supports are available to help children and adults reach and sustain recovery. Number of Individuals to be Served: Nearly 15,000 clients receiving Board funded support and treatment services, agencies providing services, as well as the entire population of Cuyahoga County. Funding Use: As needed from ADAMHS Board funding.

4 Client & System Impact: Adopting and implementing an Advocacy Action Agenda helps to better serve clients and improve the overall Cuyahoga County mental health and addiction recovery support system by focusing Board efforts, activities, decisions and funding to advance important behavioral health issues and initiatives. The 2019 Advocacy Action Agenda will help to facilitate the implementation of the Recovery Oriented System of Care. Metrics (How will success be measured) Evaluation/ Outcome Data (Actual data from program) Yearly review of Advocacy Agenda item to determine if items have been completed, completed and ongoing, or ongoing in to the next year. See CY18 Advocacy Action Program Review: o 9 Completed o 2 Completed & Ongoing o 2 Not Completed -- Ongoing Recommendation to Board of Directors from Board Staff and/or from Board Committee(s): Acceptance of 2018 Advocacy Action Agenda review and adoption of the 2019 Advocacy Action Agenda.

5 2018 Advocacy Action Agenda REVIEW Overarching Goal: The Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County has developed this Advocacy Action Agenda to guide its advocacy efforts for This agenda was developed with the overarching goal of promoting recovery of individuals living with mental illness and addictions by adopting and acting on the five Recovery Oriented System of Care principles: 1. Focusing on Clients and Families. 2. Ensuring Timely Access to Care. 3. Promoting Healthy, Safe, and Drug-Free Communities 4. Prioritizing Accountable and Outcome-Driven Financing 5. Locally Managing Systems of Care. The ADAMHS Board uses the Advocacy Action Agenda to develop messages to legislators, state agencies, policy makers, clients, families, providers and the general public to advance important behavioral health issues. Goals: Support efforts to: 1. Position the ADAMHS Board as the authority on mental health, addiction and recovery planning and convener of stakeholders throughout Cuyahoga County and Northeast Ohio to establish a responsive community network of care focused on recovery. Completed and ongoing. o Designated as the County Hub for Opioid Response, Co-Chairs of the Cuyahoga County Opiate Task Force. o Hosted Addiction Recovery Advocacy Meeting with more than 100 participants. o Participated in the U.S. District Attorney s Task Force on Opioids and Narcotics; spoke on leader panel at the September 6 conference. o Sought and obtained an AmeriCorps VISTA worker to focus on community engagement and collaboration for the opioid crisis. o Received recognition as a national model for work on the Mental Health Response Advisory Committee. 2. Develop and promote a compelling business strategy for increased federal, state and local funding to ensure the operation of a responsive community network and the establishment of a crisis and recovery services portfolio. Completed and ongoing. o Worked with Department of Justice, Medical Examiner s Office and Case Western Reserve University to obtain large grant (nearly $1 million) for data sharing to address the opioid crisis.

6 o Sought input from ADAMHS Board stakeholders (Board, staff, clients, providers, community at large, etc.) to set funding priorities for Calendar Year o Instituted a new and simplified electronic RFP process for program funding. This allowed staff to review all submissions as a team and submit a budget for review to the Board a month earlier than usual. 3. Work with Cuyahoga County Officials and all stakeholders to establish diversion/crisis centers that are accessible to police and community members. Completed and ongoing. o Supported the juvenile justice diversion program links non-violent, first time offenders with treatment, counseling and alternatives to juvenile detention. o Ensured that two crisis beds would be available and accessible 24/7. o Worked with Cuyahoga County on plans for the mental health jail diversion center. 4. Expand prevention education programs and early intervention initiatives to reduce addictions, mental illness and suicide Completed and ongoing. o Some expansions were made to school-based programming, prevention/early intervention services and early childhood mental health programming through system providers. o Surveyed the Cuyahoga County system of care regarding suicide prevention awareness and action to set 2019 goals for the Cuyahoga County Suicide Prevention coalition. o Promoted recovery and resiliency through a recovery-focused billboard campaign and social media. All information included the Crisis hotline and/or text number to increase awareness and help seeking behaviors. 5. Engage business community to reduce the stigma of mental illness and addiction and garner support for prevention and treatment initiatives not covered by insurance. Completed and ongoing. o Reviewed the drug and return to work policies for the trades worker and contractor councils. o Presented at KeyBank on the opioid crisis and best ways to assist employees. o Spoke on the Opioid Crisis to the Brecksville/Broadview Heights Chamber of Commerce o Served on an opioid panel for employees hosted by the Lyndhurst Chamber of Commerce and the CSU Small Business Development Center. o Working with Progressive Insurance to address some of the system issues (i.e. workforce development and high quality housing). 6. Develop partnerships with all stakeholders to increase access to services while developing a community provider network that is responsive and available 24-hours per day. Completed and ongoing. o Set priority process that increases 24/7 access to services for CY2019. o Contracted with the Begun Center for Violence Prevention Research at Case Western Reserve University for a Cuyahoga County Crisis Response Needs Assessment.

7 7. Develop a Crisis Intervention Policy for the community behavioral health system detailing what Crisis Intervention Team (CIT) officers can expect from our provider network. Ongoing. 8. Evaluate Cuyahoga County s mental health and addiction crisis system to improve and offer services needed by our community. Completed and ongoing. o Held webinars and stakeholder meetings to garner needs and set priorities for 2019 funding. o Shared the Recovery Oriented System of Care survey with all stakeholders to ensure that OACBHA receives input from Cuyahoga County. 9. Increase opportunities for peer recovery coaches among our provider network and other partner systems. Completed and ongoing. o Identified peer support as one of the priorities for CY2019 funding. o Continued to support programs that utilize peers support (Ascent ED, Project SOAR, Living Miracles, Magnolia Clubhouse, etc.). 10. Recognize first responders hard work and role in mental health and addiction crises. Completed. o Hosted first responder appreciation week in April of Delivered thank you packages to police, fire, EMS, hospital ERs, detox providers and other first responders in Cuyahoga County. 11. Evaluate federal, state and local legislation to determine if it benefits individuals and families living with mental illness and addiction, and communicate the Board s position to the community. Completed and ongoing. o Assisted with passing of the changed IMD Rule for substance use treatment providers o Adopted OACBHA s position on Issue 1 o Worked on HHS levy to ensure passage 12. Evaluate the training needs of our community provider network and deliver relevant and cost-effective trainings to ensure innovative and effective mental health and addiction treatment and recovery services are provided to clients and families. o Instituted a new training department to ensure that innovative and effective mental health and addiction treatment and recovery training is available to the Cuyahoga County system of care. 13. Increase local funding opportunities for mental health and addiction recovery services, including the feasibility of a separate and dedicated ADAMHS Board levy. Ongoing.

8 Stay Informed About Advocacy Efforts The Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County offers Cuyahoga County residents an opportunity to stay informed and become involved as advocates for mental health and alcohol and other drug addiction issues. Clients, family members, providers and the public may request placement on the ADAMHS Board's distribution list. Reverend Benjamin F. Gohlstin, Sr. Board Chair Scott S. Osiecki Chief Executive Officer Being on our distribution list allows you to stay informed by receiving the latest news and action alerts about legislation and other issues impacting mental health and alcohol and other drug addiction in Cuyahoga County, the state of Ohio and the United States. To have your name placed on our distribution list, or to obtain more information about the Advocacy Action Agenda, contact: Beth Zietlow-DeJesus, Director of External Affairs or , ext. 812 Another way to stay informed is to visit the ADAMHS Board's Web site at You can find client and family information, service providers, facts about mental health and alcohol and other drug addiction, news and legislation, Board publications and general information about the Board. You can also find us on Facebook, Instagram and Twitter. Cover artwork was created by a client of JFSA -The Plan. The client did a vegetable stamping project as part of the art therapy program, which allows for personal expression while encouraging healing West 25th Street, 6th Floor Cleveland, Ohio Phone: (216) Web: Advocacy Action Agenda

9 Overarching Advocacy Objectives for 2019: The Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County has developed this Advocacy Action Agenda to guide its advocacy efforts for This agenda was developed with the overarching goal of promoting recovery of individuals living with mental illness and addictions by adopting and acting on the five Recovery Oriented System of Care principles: 1. Focusing on Clients and Families. 2. Ensuring Timely Access to Care. 3. Promoting Healthy, Safe, and Drug-Free Communities 4. Prioritizing Accountable and Outcome-Driven Financing 5. Locally Managing Systems of Care The ADAMHS Board uses the Advocacy Action Agenda to develop messages to legislators, state agencies, policy makers, clients, families, providers and the general public to advance important behavioral health issues. Goals: NEW: Support the State-wide Recovery is Beautiful movement to ensure that a Recovery Oriented System of Care is developed and implemented in Cuyahoga County, through client and family involvement; community education; integrated behavioral health, spirituality and wellness; peer support; timely access to services; quality of care and performance-based contracting and financing. Expand prevention programs and early intervention initiatives to reduce addictions, mental illness and suicide in Cuyahoga County. NEW: Support efforts to combat the evolving fentanyl/opioid epidemic in Cuyahoga County and the State of Ohio and prepare for historical trend of stimulant abuse following such crises. NEW: Support efforts to increase access to high-quality housing for individuals living with and recovering from mental illness and addictions. NEW: Support efforts to increase the number of practitioners available to provide mental health and addiction services, including MAT and psychiatric services for both youth and adults and assist provider network in recruiting staff. Support prevention activities, public awareness efforts and training to reduce the stigma of mental illness and/or addictions and educate the community by featuring client personal recovery success stories. Support continued Crisis Intervention Training for Officers throughout Cuyahoga County. Develop a Crisis Intervention Policy for the community behavioral health system detailing what Crisis Intervention Team (CIT) officers can expect from our provider network. Support efforts to increase the availability of peer supporters for both mental health and addictions in Cuyahoga County. Support efforts to address increasing suicide rates through suicide prevention education, awareness and training. NEW: Support efforts to increase employment for people living with mental illness and/or addictions, including certified Recovery Coaches, with the Board provider agencies. NEW: Support efforts to ensure that culturally competent programs are in place to address health equity and disparities in Cuyahoga County. NEW: Support efforts to increase coordination with managed care organizations to help integrate services. Support and evaluate state and federal legislation to determine if it benefits individuals and families living with mental illness and/or addictions and communicate the Board's position to the community. Develop partnerships with stakeholders to increase access to services while developing a community provider network that is responsive and available 24-hours per day. Support efforts to position the ADAMHS Board as the authority on behavioral health issues and convenor of stakeholders to address the local mental health and addiction recovery needs of the community, including the continuation of the Addiction Recovery Advocacy Meetings. Support efforts to achieve dedicated local funding for mental health and addiction support services by examining opportunities for a dedicated ADAMHS Board of Cuyahoga County Mental Health and Addiction Recovery Services levy. Support the Ohio Association of County Behavioral Health Authorities (OACBHA) 20/21 Biennial Budget platform that focuses on increasing state funding to support a Recovery Oriented System of Care. NEW: Support efforts that address barriers and access to treatment and recovery through innovation and continuity of care. 10/30/18

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21 Agenda Process Sheet Date: November 14, 2018 Community Relations & Advocacy Committee Faith-Based Outreach Committee Planning & Oversight Committee Finance & Operations Committee Committee of the Whole General Meeting Topic: Contractual Parties: Peer Seal of Quality for Adult Care Facilities (ACFs) Program Individual Peer Supporters TBD Term: November 30, 2018 January 31, 2019 Funding Sources: Amount: ADAMHS Board Funding $50.00 per Home Visit ($25 per peer in teams of two) Estimate of $4,800 based on 96 ACFs to be visited. New Program Continuing Program Expanding Program Other: ACF Peer Quality Program Service Description: The ADAMHS Board of Cuyahoga County is seeking to develop a preferred list of ACFs to provide safe, decent and affordable housing for individuals living with mental illness. The Peer Seal of Quality for ACFs Program is designed to help the ADAMHS Board with this process. Background Information: The ADAMHS Board will contract with certified Peer Specialists and Peers in the process of becoming certified to conduct home visits of the ACFs that have submitted responses to the Board Request for Proposals (RFPs) to be eligible to provide housing to individuals with mental illness funded through the Board s Residential Assistance Program (RAP). The Peers will perform the home visits in teams of two per home. During the home visits the teams will perform a walk through and visual assessment of the residence, take photos, complete a checklist and provide a recommendation of a Peer Seal of Approval. The home visit is not a licensing inspection all of the homes will already be licensed by OhioMHAS. The Peers will be looking for cleanliness, upkeep of the property (carpets, floors, cabinets, appliances, visual leaks, utensils, etc.), supply, availability and quality of food, clean sheets and towels, adequate toiletries, etc. The Peers and the home visits will be coordinated by Craig Dunson, of Lifeworks Behavioral Health Solutions a peer operated organization. Number of Individuals to be Served: Funding Use: Clients living in ACFs. To pay Peers to conduct the home visits.

22 Client & System Impact: Begin the process of ensuring that clients on RAP are living in quality, clean, safe, decent and affordable housing. Metrics (How will success be measured) Evaluation/ Outcome Data (Actual data from program) Number of peers that the Board contracts with to perform the home visits. Number of Home Visits conducted. Number of ACFs that receive the Peer Seal of Quality. N/A New Program Recommendation to Board of Directors from Board Staff and/or from Board Committee(s): Approval to contract with Peers to conduct Home Visits to the ACFs that responded to the Board s RFP as part of the Peer Seal of Quality for ACFs Program.

23 CONTRACTS and CONTRACT AMENDMENTS Committee of the Whole Meeting November 14, 2018

24 Agenda Process Sheet Date: November 14, 2018 Community Relations & Advocacy Com. Planning & Oversight Committee Committee of the Whole Faith-Based Outreach Committee Finance & Operations Committee General Meeting Topic: Substance Abuse and Mental Health Services Administration (SAMHSA) Assisted Outpatient Treatment (AOT) Program Supplemental Technical Assistance Funding Contractual Parties: Trainers TBD Term: September 29, 2018 to September 29, 2019 Funding Source(s): Substance Abuse and Mental Health Services Administration Amount: $25, New Program Continuing Program Expanding Program Other Service Description: The ADAMHS Board of Cuyahoga County has received a one-year supplemental award totaling $25, from the Substance Abuse and Mental Health Services Administration as part of the Board s existing Assisted Outpatient Treatment Program. Each AOT program around the country was awarded these funds in order to conduct technical assistance activities within its project. Funding can only be used for technical assistance. The ADAMHS Board will use these funds over the course of the current grant year to provide training to Frontline staff (the direct service provider in this program) and other system partners as appropriate. Suggested topics are: 1) addressing violent/aggressive behaviors in clients with Serious Mental Illness; 2) managing clients with co-occurring disorders; 3) cultural competence; 4) strategies for building staff resilience; 5) project sustainability; and 6) other topics as identified. Background Information: Prior to this, SAMHSA had a contract with a Technical Assistance provider, who offered workshops and webinars to all AOT projects nationally. SAMHSA did not renew this contract. SAMHSA awarded funding to enable AOT projects to provide on-site technical assistance tailored to their specific needs. Number of Individuals to be Served: N/A Funding Use: Funding will be utilized to contract with individual trainers through the year to provide training to Frontline staff and other system partners.

25 Client & System Impact: To strengthen the behavioral health system to better serve clients with severe mental illness (SMI), and their families, who are engaged in the Assisted Outpatient Treatment program. Metrics (How will goals be Measured) Number of trainings conducted Number of attendees at each training Evaluation/Outcome Data (Actual results from program) Minimum of five 2 day trainings to be conducted Approximately 50 attendees at each training. Recommendation to Board of Directors from Board Staff and/or from Board Committee(s): Board staff requests approval from the ADAMHS Board of Directors to receive funds in the amount of $25, from SAMHSA to provide Technical Assistance within the AOT project and to enter into personal service contracts with individuals throughout the year.

26 Agenda Process Sheet Date: November 14, 2018 Community Relations & Advocacy Committee Faith-Based Outreach Committee Planning & Oversight Committee Finance & Operations Committee Committee of the Whole General Meeting Topic: Contractual Parties: Contract with: Intensive Community Treatment (ICT) Team for Cleveland Adult Parole Office Accept Funds from: Ohio Department of Rehabilitation and Corrections (ODRC) Recovery Resources Term: July 1, 2018 to June 30, 2019 Funding Source(s): Amount: State Pass-Through Funds $275, ODRC allocation New Program Continuing Program Expanding Program Other Service Description: The ICT Parole Program operated by Recovery Resources provides assertive community treatment for persons being released from Prison on Parole or Post Release Control. The ICT Parole Program maintains an active caseload for up to 50 people at any given time. The program provides intensive community support services, assistance with housing and other supports. A designated Officer from APA is assigned to the Team in order to assist and support the team. Recovery Resources will continue to provide intensive community support services to the mentally ill population being released from prison that are on Parole and or Post Release Control. Background Information: Acceptance and allocation of pass through state dollars from the Ohio Department of Rehabilitation and Corrections (ODRC) allocation in the amount of $275, for the ICT Parole Program to Recovery Resources. Number of Individuals to be served: 50 Funding Use: To provide intensive community support services to the mentally ill population being released from prison that are on Parole and or Post Release Control. Client & System Impact: Improved functioning in social and employment, secure housing, decrease in parole violations Reduce psychiatric hospitalizations, decrease of systems and overall stabilization of clients served

27 Program/Service Goals: Improved functioning in social and employment roles Secure housing Decrease in parole violations and new charges Reduce utilization of psychiatric hospitalizations Measure and document the decreasing or elimination of the symptoms of mental illness Metrics (How will success be measured) 50 clients to receive P/ICT services Approximately 50% will be discharged At least 30% will complete successfully Evaluation/ Outcome Data (Actual results from program) N/A Recommendation to Board of Directors from Board Staff and/or from Board Committee(s): For the Board of Directors to accept the amount of $275, from ODRC and contract with Recovery Resources in this amount for the period July 1, 2018 through June 20, 2019 for the Intensive Community Treatment (ICT) Team.

28 Agenda Process Sheet Date: November 14, 2018 Community Relations & Advocacy Committee Faith-Based Outreach Committee Planning & Oversight Committee Finance & Operations Committee Committee of the Whole General Meeting Topic: Contractual Parties: Mental Health Services in the Cuyahoga County Juvenile Court Detention Center Applewood Centers Term: January 1, 2019 December 31, 2019 Funding Source(s): ADAMHS Board Funding Amount: $400, New Program Continuing Program Expanding Program Service Description: Other The Mental Health Services in the Cuyahoga County Juvenile Court Detention Center program is designed to stabilize youth with mental health challenges who are detained within the Detention Center, as well as provide consultative guidance and education regarding mental health and behavioral issues to Detention Center staff. A dedicated team of licensed clinicians provides the following mental health services to youth identified by Juvenile Court within each of the five housing units of the Detention Center: brief solution focused therapy, suicide risk assessments, linkage and coordination, and crisis intervention when indicated. As an adjunct to the model, a child/adolescent psychiatrist provides pharmacological assessment and medication management up to eight hours per week. Background Information: As Juvenile Court has continued to expand its diversion efforts over the past decade, the demographics of the Detention Center have significantly changed. Low-risk offenders are increasingly diverted, and the remaining population of detained youth consist of those who have committed more serious offenses, thus increasing the average length of stay. Many of these youth experience increased mental health symptoms during admission, as well as over the course of their detainment. During 2018, a series of incidents occurred within the Detention Center which led to a reform strategy which included an independent assessment of the conditions of the Detention Center. The Center for Children s Law and Policy reviewed materials and conducted the assessments over a period of two months. The recommendation report was released September of 2018 and disseminated to the public in mid-october. The recommendations cover operations, staffing, programming, training, restraints, safety, etc. Number of Individuals to be served: In 2019, Applewood Centers projects to provide initial brief functional behavioral assessments and/or suicide risk assessments to approximately 700 youth identified through the Detention Center, and to provide ongoing mental health services to approximately 300 of those youth.

29 Funding Use: Funding will be utilized to ensure adequate coverage within the Juvenile Court Detention Center for the provision of mental health services, pharmacological assessment & monitoring, and consultative guidance and education to Detention Center staff. Client & System Impact: Increased access to mental health services for detained youth, resulting in fewer behavioral incidents and improved overall functioning. Increased utilization of effective responses by Detention Center staff to behaviors connected to a youth s mental health challenges. Diversion of youth with significant mental health challenges away from detention and into a clinically appropriate setting for evaluation and recommendations. Metrics (How will goals be measured) In Calendar Year 2019, Applewood projects to meet the following measures for youth served through the Mental Health Services in the Detention Center program: Identify the total number of youth receiving an initial assessment Identify the number of youth receiving ongoing mental health services Identify the number of youth discharged from ongoing mental health services 50% of discharged youth will demonstrate fewer risk behaviors on the Crisis Assessment Tool 50% of discharged youth will demonstrate improved behavioral and emotional symptoms on the Crisis Assessment Tool 50% of discharged youth will demonstrate improved life domain functioning on the Crisis Assessment Tool 50% of discharged youth will demonstrate improved community safety rating on the Crisis Assessment Tool Evaluation/ Outcome Data (Actual results from program) In Calendar Year 2018 through the Third Quarter, Applewood reported the following measures for youth served through the Mental Health Services in the Detention Center program: 602 youth received an initial assessment 216 youth received ongoing mental health services 159 youth were discharged from ongoing mental health services 65% (103 of 159) of discharged youth demonstrated fewer risk behaviors on the Crisis Assessment Tool 69% (109 of 159) of discharged youth demonstrated improved behavioral and emotional symptoms on the Crisis Assessment Tool 58% (92 of 159) of discharged youth demonstrated improved life domain functioning on the Crisis Assessment Tool 39% (62 of 159) of discharged youth demonstrated an improved community safety rating on the Crisis Assessment Tool Recommendation to Board of Directors from Board Staff and/or from Board Committee(s): To recommend approval to the Board of Directors to contract with Applewood Centers for the provision of the Mental Health Services in the Cuyahoga County Juvenile Court Detention Center program in the amount of $400, for the period January 1, 2019 through December 31, 2019.

30 Agenda Process Sheet Date: November 14, 2018 Community Relations & Advocacy Committee Faith-Based Outreach Committee Planning & Oversight Committee Finance & Operations Committee Committee of the Whole General Meeting Topic: Contractual Parties: Term: Funding Source(s): Security Services Contract Safe Choice LLC January 1, 2019 through December 31, 2019, with the option for a one-year renewal for calendar year 2020 ADAMHS Board Operating Budget Amount: $17.50/Hour Annual Estimate for CY2019 $127,750 (Anticipated Savings of $4,250 from CY2018) New Program Continuing Program Expanding Program Other Security Services Service Description: Armed security guard services provided at the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board s administrative office located at 2012 West 25 th Street, Cleveland, Ohio, during the hours of 7:00 a.m. 6:30 p.m., Monday through Friday, as well as Seasons of Hope building during the hours of 7:00 p.m. 7:00 a.m., Sunday through Saturday. Duties include but are not limited to: building opening and closing inspections; foot patrol of building, visual surveillance, visitor check-in and physical presence in the ADAMHS s Board entrance during employee arrival/departure times and evening meetings, and participation in workplace violence reduction trainings and procedure drills. Background Information: The ADAMHS Board currently contracts with Tenable Protective Services for armed security guard services through December 31, Tenable Protective Services is paid for services provided on an hourly basis at $17.62 per hour for regular hours, and $26.43 for overtime hours. In September 2018, the ADAMHS Board of Directors authorized Board staff to release a Request for Proposal (RFP) on October 1, 2018 to secure bids for security services in accordance with the Purchasing policy. The ADAMHS Board received three responses to the RFP by the October 19, 2018 deadline. The proposals were reviewed and discussed by the RFP Review Committee which was appointed by the ADAMHS Board s Chief Executive Officer. The RFP Review Committee is recommending that Safe Choice LLC is awarded a one-year security contract for the ADAMHS Board s Administrative Office and Seasons of Hope building, starting January 1, 2019 through December 31, 2019, with the option for a one-year renewal at a new negotiated rate.

31 Safe Choice LLC will be paid for services provided on an hourly basis for armed security guard officers at $17.50 per hour. Several guards will be staffed to cover the shifts to eliminate the need for overtime. Safe Choice LLC was selected on hourly rate and references. Safe Choice LLC is certified by the state as a Minority Business Enterprise (MBE) and Encouraging Diversity, Growth and Equity (EDGE) program. Number of Individuals to be served: ADAMHS Board and Seasons of Hope employees and visitors. Funding Use: Armed security guard services for ADAMHS Board administrative office and Seasons of Hope. Client & System Impact: Deterrent, safety of clients and staff, and de-escalation when needed. Metrics (How will goals be measured) Evaluation/ Outcome Data (Actual results from program) Security guard attendance, punctuality and responsiveness. N/A Recommendation to Board of Directors from Board Staff and/or from Board Committee(s): To approve a one-year contract with Safe Choice LLC for armed security guard services at the ADAMHS Board s administrative office located at 2012 West 25 th Street, Cleveland, Ohio, during the hours of 7:00 a.m. 6:30 p.m., Monday through Friday, as well as Seasons of Hope building during the hours of 7:00 p.m. 7:00 a.m., Sunday through Saturday, in an amount of $17.50 per hour from January 1, 2019 through December 31, 2019, with the option for a one-year renewal for calendar year 2020, at a new negotiated rate.

32 Agenda Process Sheet Date: November 14, 2018 Community Relations & Advocacy Committee Faith-Based Outreach Committee Planning & Oversight Committee Finance & Operations Committee Committee of the Whole General Meeting Topic: Request to hold the ADAMHS Board of Cuyahoga County Annual Meeting Brunch and Awards Ceremony on Monday, May 13, 2019, and enter into an Operational Contract with Cleveland Marriott East, Warrensville Heights, Ohio Contractual Parties: Cleveland Marriott East Harvard Rd. Warrensville Hts., OH Term: November 30, 2018 June 30, 2019 Funding Sources: Amount: ADAMHS Board Funding Not to exceed $15, (based on 450 people) in food and beverage, inclusive of service charge, room rental and A/V. (Food & service charge to be covered by ticket sales.) New Program Continuing Program Expanding Program Other: Annual Meeting Service Description: The ADAMHS Board of Cuyahoga County holds its Annual Meeting Brunch and Awards Ceremony every year. During this meeting, the Board presents its Annual Report to the Community and its Annual Awards. Background Information: The Annual Meeting has traditionally attracted between 350 and 519 guests and is held during May. The ADAMHS Board sells tickets to the event to defray the cost of the food and service charge. The 2018 Annual Meeting was held on May 14, 2018 at LaCentre Westlake. A total of 391 people attended. $10, was raised through ticket sales. LaCentre s cost was $13, The cost of awards was $1, Total cost to the Board for the meeting was $4, Based on considerable research for various downtown, east side and west side locations to host the meeting over the past few years, in addition to the Board requirement for free self-parking and easy highway and bus access, staff is requesting to host the 2019 Annual Meeting at Cleveland Marriott East located at Harvard Rd., Warrensville Hts., Ohio. Cleveland Marriott East can accommodate a group of up to 700 people seated at banquet tables in the full ballroom. Number of Individuals to be Served: Approximately 450 people. Funding Use: To defray the cost of Annual Meeting expenses not covered by ticket sales.

33 Client & System Impact: During the Annual Meeting, the Board provides a yearly update to the community and acknowledges exceptional accomplishments in the community through the presentation of awards to clients, family members, legislators and professionals. Metrics (How will success be measured) Evaluation/ Outcome Data (Actual data from program) Number of people in attendance at the Annual Meeting. Total cost to the Board after ticket sales. 391 people attended 2018 Annual Meeting. $10, was raised through ticket sales. LaCentre Westlake s cost was $13, Awards cost was $1, Total cost to the Board for the meeting was $4, Recommendation to Board of Directors from Board Staff and/or from Board Committee(s): Approval to hold the 2019 Annual Meeting Brunch and Award Ceremony on Monday, May 13, 2019, and enter into an Operational Contract with Cleveland Marriott East.

34 Agenda Process Sheet Date: November 14, 2018 Community Relations & Advocacy Committee Planning & Oversight Committee Committee of the Whole Faith-Based Outreach Committee Finance & Operations Committee General Meeting Topic: Cultural Competency Breakfast: Monday, January 28, 2019 Contractual Parties: Ariel International Center, 1163 East 40th St #201, Cleveland, OH Caterer: Taste of Excellence Presenter: Dr. Ciara Dennis-Morgan Term: November 29, 2018 February 28, 2019 Funding Source(s): ADAMHS Board Funds Amount: Up to $5, New Program Continuing Program Expanding Program Other Service Description: Dr. Ciara Dennis-Morgan, Clinical Director for Minority Behavioral Health Group, will present on delivering system-wide culturally competent services. Background Information: Host an educational provider breakfast to assist in the understanding of how to provide culturally appropriate and comprehensive services. The event will be held in January of 2019 at the Ariel International Center from 8:30 a.m. 11:30 a.m. on Monday, January 28, This is part of the Board s ongoing efforts to ensure that system providers understand and apply cultural competencies in their organizations services and recovery supports. Number of Individuals to be Served: Approximately 150 people. Funding Use: To pay the cost for the venue, caterer and audio visual equipment. Client & System Impact: Raise providers awareness of how to implement culturally specific programming. Page 1 of 2

35 Metrics (How will success be measured) Evaluation/ Outcome Data (Actual data from program) Number of people in attendance at the breakfast. Increase the knowledge of culturally competent programming. N/A Recommendation to Board of Directors from Board Staff and/or from Board Committee(s): Approval to hold the Cultural Competency Breakfast in January of 2019 and enter into operational contracts in a total amount not to exceed $5, with Ariel International Center, Taste of Excellence, and a personal service contract with Dr. Ciara Dennis-Morgan. Page 2 of 2

36 Agenda Process Sheet Date: November 14, 2018 Community Relations & Advocacy Com. Planning & Oversight Committee Committee of the Whole Faith-Based Outreach Committee Finance & Operations Committee General Meeting Topic: Amendment to Resolution No : Approval of Contracts - Projects for Assistance in Transition from Homelessness (PATH) and Acceptance of Additional Housing Funding Contractual Parties: FrontLine Service Term: July 1, 2017 to December 31, 2018 Funding Source(s): Ohio Department of Mental Health & Addiction Services (OhioMHAS) FY2018 PATH Grant Funding Amount: $13, New Program Continuing Program Expanding Program Other: Pass-Thru Funds Service Description: OhioMHAS awarded an additional $13, to provide housing services within the PATH Program for project year The period to expend these funds for PATH clients was extended by OhioMHAS to December 31, No match is required for these funds. Background Information: FrontLine is the provider of PATH services in Cuyahoga County and determined there was a need for these additional funds to serve PATH clients. Number of Individuals to be Served: N/A; Pass through funds Funding Use: Funding will be utilized to pay for housing for PATH clients Client & System Impact: Additional funding will be available for individuals in need of housing services. Metrics (How will goals be measured) Evaluation/Outcome Data (Actual results from program) N/A Pass through Funds N/A Pass through Funds Recommendation to Board of Directors from Board Staff and/or from Board Committee(s): Board staff requests approval from the ADAMHS Board of Directors to receive funds in the amount of $13, from OhioMHAS and to amend the 2018 PATH contract with FrontLine Service.

37 Agenda Process Sheet Date: November 14, 2018 Community Relations & Advocacy Committee Faith-Based Outreach Committee Planning & Oversight Committee Finance & Operations Committee Committee of the Whole General Meeting Topic: Contractual Parties: Amendment of Resolution , Consulting Contract for Remote Network Administration Christopher P. Tomaro Term: Extension January 1, 2019 through March 31, 2019 Funding Source(s): Amount: Board Operating Budget $45.00 per hour on an as needed basis New Program Continuing Program Expanding Program Other Personal Service Contract Service Description: Remote network administration for ADAMHS Board systems. Background Information: Christopher Tomaro served as the Network & Systems Specialist for the ADAMHS Board of Cuyahoga County for approximately four and one-half years. His last day of employment with the Board was March 13, In order to assist the Board with network administration, the Board entered into a short-term contract with Mr. Tomaro that allows remote access to the Board s network on an as needed basis at $45.00 per hour. The position was filled temporarily but is currently vacant and network administration services are still necessary. Number of Individuals to be served: All Board Staff Funding Use: Ensure continued operation of the Board s network. Client & System Impact: Ensure continued operation of the Board s network so that staff may continue to use computers and the network to perform duties that impact our clients and providers.

38 Metrics (How will goals be measured) Hours worked Issues resolved Evaluation/ Outcome Data (Actual results from program) Hours worked Total hours of service provided through October 31, hours Issues resolved Various issues resolved including: system updates, machine maintenance, phone system configurations, connectivity issues, server maintenance. Also participated in screening prospective position candidates and training. Recommendation to Board of Directors from Board Staff and/or from Board Committee(s): To amend Resolution to extend the contract with Christopher P. Tomaro for network administration at $45 per hour on an as needed basis until March 31, 2019.

39 Agenda Process Sheet Date: November 14, 2018 Community Relations & Advocacy Committee Faith-Based Outreach Committee Planning & Oversight Committee Finance & Operations Committee Committee of the Whole General Meeting Topic: Contractual Parties: Amendment of Resolution , Approval & Ratification of Service Provider Contracts: Common Pleas Court/Corrections Planning Board (CCPB) Residential Services for Men who are Dually Diagnosed Catholic Charities/Matt Talbot Term: July 1, 2017 through June 30, 2019 Funding Source(s): Cuyahoga County Corrections Planning Board ADAMHS Board Funds Amount: Not to exceed $160, $80, CCPB - $80, ADAMHS Board New Program Continuing Program Expanding Program Other Service Description: The purpose of the funding is to provide Residential Level of Care services for men who are dually diagnosed currently being supervised by the Probation Department in Cuyahoga County. This contract is being amended to reflect the required match that was inadvertently left off of Resolution No Background Information: The collaboration between the Courts and treatment providers is intended to provide a comprehensive team approach between the Probation Department and treatment providers to address issues related to being dually diagnosed, identify risky behaviors and reduce incarceration within the dually diagnosed male population. The Residential Services for Men who are Dually Diagnosed is a collaborative between the Cuyahoga County Common Pleas Court/Corrections Planning Board, the ADAMHS Board and the selected provider who will work with the Probation Department Dual Diagnosis unit as related to admission service delivery and discharge decisions. Length of residence, discharge and re-admission under this contract shall be subject to team staffing. The Corrections Planning Board monitors the use of the funds for residential services for men who are dually diagnosed through site visits to Catholic Charities Services (Matt Talbot for Men), the identified service provider for this program. Target population for utilizing this funding are identified as male Cuyahoga County residents identified as having a dual diagnosis and currently under the supervision of the Court s Probation Department.

40 Number of Individuals to be served: 100 new clients per year. Funding Use: To coordinate referral and linkage to existing IOP substance services following residential treatment in order to facilitate recovery. Client & System Impact: To provide residential treatment services to dually diagnosed, justice system involved residents of Cuyahoga County in order to achieve sobriety, stability, maintain long-term recovery, and divert from prison. Metrics (How will goals be measured) Evaluation/ Outcome Data (Actual results from program) Completion of substance abuse treatment Recidivism The Court of Common Please is in the process of conducting a three (3) year postprobation recidivism study with the described population. Recommendation to Board of Directors from Board Staff and/or from Board Committee(s): To amend Resolution to correct funding sources listed. The total project amount is $160,000.00; $80, from the Corrections Planning Board and $80, from the ADAMHS Board.

41 ALCOHOL DRUG ADDICTION AND MENTAL HEALTH SERVICES BOARD OF CUYAHOGA COUNTY POLICY STATEMENT SUBJECT: NOTIFICATION AND REVIEW OF REPORTABLE INCIDENTS & MUIs EFFECTIVE DATE: November 21, 2013 October 24, 2018 tentative PURPOSE To assist contract service providers, Ohio Department of Mental Health and Addiction Services (OhioMHAS) licensed residential care facilities (RCFs) and licensed adult care facilities (ACFs) in recognizing and reporting incidents and events that they are required to report to the Alcohol, Drug Addiction and Mental Health Services Board of Cuyahoga County Community (ADAMHS BOARD) and other entities. To define the ADAMHS BOARD activities of reviewing such reports as within the scope of the ADAMHS BOARD s performance improvement process and to define the ADAMHS BOARD s responsibilities to report and investigate incidents. POLICY It is the policy of the ADAMHS BOARD to require all contract service providers, RCFs, and ACFs and residential care facilities to comply with the Ohio Revised Code (O.R.C.), the Ohio Administrative Code (OAC) and ADAMHS Board provisions concerning the reporting of reportable incidents, major unusual incidents and allegations of abuse and neglect. The ADAMHS BOARD, the contract service providers, and RCFs and ACFs shall review each individual reportable incident and systematically monitor and analyze reportable incidents. DEFINITIONS 1. Definitions applicable to Contract Service Providers (including AoD providers of residential treatment services) pursuant to OAC or the ADAMHS Board: a. Incident means any event that poses a danger to the health and safety of clients and/or staff and visitors of the agency, and is not consistent with routine care of persons served or routine operations of the agency. b. Reportable Incidents or Major Unusual Incidents (which may include major unusual incidents as referred to in O.R.C ), are incidents that must be submitted to the OhioMHAS and to the ADAMHS BOARD., including incidents that must then be forwarded by the OhioMHAS to the Ohio Legal Rights Service (OLRS) pursuant to section of the Revised Code. Reportable incidents are those that involve consumers/clients and shall include deaths, serious bodily injuries, alleged criminal acts, alleged physical or sexual abuse or neglect, any adverse reaction of a client to a life threatening degree due to an administered drug, medication errors likely to result in serious consequences to a client, and any life threatening situations. (As referenced in division (C) of section of the Revised Code, Major Unusual Incident has the same meaning as Reportable Incident. ) Page 1 of 9